Permit .. ,
CITY OF TIGARD
MECHANICAL PERMIT �-'
o : COMMUNITY DEVELOPMENT Permit #: MEC2013 -00148
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/18/2013
Parcel: 2S 103DA00300
Jurisdiction: Tigard
Site address: 13120 SW WATKINS AVE
Project: Boles Subdivision: DERRY -DELL Lot: 3
Project Description: (1) gas furnace installation (switching from electric to gas) and (1) fuel piping
Contractor: OWNER Owner: BOLES, PATRICIA ANN & JERRY LYNN
13120 SW WATKINS AVE
TIGARD, OR 97223
PHONE: PHONE: 503 - 277 -8044
FAX:
FEES •
Specifics: Description D ate Amount
Furnaces < 100K BTU 03/18/2013 $46.75
Type of Use: SF Fuel Piping 03/18/2013 $14.15
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/18/2013 $29.10
Occupancy Grp: 12% State Surcharge - Mechanical 03/18/2013 $10.80
Stories: (manual)
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
•
Required Items and Reports (Conditions)
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued By: / / / / /LA Permittee Signature: i ‘ + jpfr
..i.rdra..2 j
Call 503.639.4175 by 7:00 a.m. for the next available inspection . : '
This permit card shall be kept in a conspicuous place on the job site until com Icon of the project.
P
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit A lication FOR OFFICE USE ONLY
City of Tigard EIVED ReceiDate/By: ved 1 ✓ I r/ ¢ ( 3 Gt�O/ 3���
5r Permit No.: /� [ J/
`J
13125 SW Hall Blvd., Tigard,OR 97223
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 MAR 18 Z013 Date/By: Other Permit:
TI G A R D Inspection Line: 503.639 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: /1t Supplemental Information
CITY OFTIGARD
TYPE OF I JI,DING DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: J 3 / z 0 k ) I I 46.75
City /State /ZIP: / W a fi� 'Furnace 100,000 BTU (ducts /vents) f 46.75
-Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace/insert 33.39
g o,./.1 I h 4' w ( ha e_.--c_ Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
al PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: . rte 1 'a Q 1 %-t- Environmental exhaust and ventilation:
Address: /
Range hood/other kitchen
2,0 w �Ct t equipment 33.39
City/State /ZIP: 4 i e , ,d, 0 172 23 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
1,
Phone: ( ) .2_ 2 e- f if Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name:
Other: 23.32
Fuel piping:
Contact name: $14.15 for first four; $4.03 for each additional
Address:
Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: State surcharge (12% of permit fee)
TOTAL PERMIT FEE 1(5)).1)
Authorized signature: This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Permits\ME.0 - PermitApp.doc 03 /07/12 440 -46I7T (I I /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
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Commercial & Multi - Family Fee Schedule:
Total Valuation: Permit Fee: •
$0.00 to $500.00 Minimum fee $69.06
•
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$1 0,000.01 to $50,000.00 $347.71 for the first $1 0,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1.•\ Building \Pemiits\MEC- PermitApp.doc 03/07/12 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13120 SW WATKINS AVE, TIGARD, OR, 97223
Residential - Mechanical
610 Gas Line
04/09/2013 00:00
MEC2013-00148
PASS
Standard pressure verified 10 lbs15 min
Violation Summary:
Inspector Contractor